DR. ROBERT WILLIAM ELLIS III (NPI# 1124006549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124006549 |
| Entity Type | Individual |
| Full Name | DR. ROBERT WILLIAM ELLIS III |
| Credential | MD |
| Practice Address |
204 W Grand River Ave Suite 260 Howell MI 48843-2299 |
| Practice Telephone | 5175451010 |
| Practice Fax Number | 5175451025 |
| Mailing Telephone | 5175451010 |
| Mailing Fax Number | 5175451025 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2012-06-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4301097679 | MI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
4301097679 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881945566 | Robert Ray Ellis | Military Health Care Provider | 10194 Cottage Ct, Diberville, MS 39540-4744 | 2012-09-21 |
| 1336392224 | Robert Ellis | Specialist/Technologist, Other | 8008 Blue Hole Ct, Mckinney, TX 75070-4896 | 2008-10-23 |
| 1124274394 | Robert Stephen Ellis | Dentist | 1434 - Parker Drive, Laurel, MS 39440-1942 | 2008-08-07 |
| 1083810709 | Robert Haig Ellis | Internal Medicine | 2412 Brookwood Drive, Fort Collins, CO 80525-1908 | 2007-06-21 |
| 1265534697 | Robert Frank Ellis | Obstetrics & Gynecology | 770 Elysian Way, Deerfield, IL 60015-4500 | 2006-09-05 |
| 1083724843 | Robert Lynn Ellis | Dentist | 143 1/2 E Main, Rigby, ID 83442 | 2006-08-30 |
| 1932111739 | Robert George Ellis | Radiology | 1204 E 29th St, Tulsa, OK 74114-3907 | 2006-08-12 |
| 1366461337 | Robert Earle Ellis | Counselor | 273 Front St, Weymouth, MA 02188-2202 | 2006-07-19 |
| 1689185936 | Robert Brian Ellis | Audiologist | 318 W El Norte Pkwy, Escondido, CA 92026-1925 | 2017-10-13 |
| 1316467277 | Robert Tyler Ellis | Orthopaedic Surgery | 1100 Virginia Avenue Dc 953 00, Columbia, MO 65212-0001 | 2017-06-22 |
| Street Address |
204 W GRAND RIVER AVE SUITE 260 |
| City | HOWELL |
| State | MI |
| Zip Code | 48843-2299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518402247 | Mary Frances Spence | Psychologist | 204 W Grand River Ave, Suite 260, Howell, MI 48843-2299 | 2017-01-04 |
| 1487942983 | Pamela Christine Ketchel | Massage Therapist | 204 W Grand River Ave, Suite 240, Howell, MI 48843-2299 | 2011-07-18 |
| 1770657835 | Ryan Breasbois | Dentist | 204 W Grand River Ave, Suite 220, Howell, MI 48843-2299 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770050775 | Kaylee Primeau | Behavioral Analyst | 3292 Beck Rd, Howell, MI 48843 | 2018-10-28 |
| 1750869988 | Leanna Lynn Lopez | Occupational Therapist | 4286 Mcgunn Rd, Howell, MI 48843 | 2018-07-31 |
| 1942719133 | Tracey Ann Ulmer | Specialist | 622 Grand River, Howell, MI 48843 | 2017-09-20 |
| 1649792292 | Livingston Psychological Services, Pllc | Psychologist | 204 W Grand River Ave Ste 260, Howell, MI 48843 | 2017-07-14 |
| 1558817288 | Amy Binns | Technician, Other | 5280 Whistler Pt, Howell, MI 48843 | 2016-09-01 |
| 1033571112 | Diversified Counseling and Consulting Services, Pllc | Social Worker | 1004 S. Michigan Ave., Suite 203, Howell, MI 48843 | 2016-03-28 |
| 1174998801 | Level Eleven Howell | Clinic/Center | 1030 W. Highland Rd, Howell, MI 48843 | 2015-12-07 |
| 1285021170 | Frances Vitale | Behavioral Analyst | 308 Tullamore St, Howell, MI 48843 | 2015-04-19 |
| 1487059671 | Michigan Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 1800 Dorr Rd., Howell, MI 48843 | 2014-10-30 |
| 1720483027 | Assuredtrans Services, Inc. | Non-emergency Medical Transport (VAN) | 1800 Dorr Rd, Howell, MI 48843 | 2014-10-29 |
| Find all providers in zip 48843 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316376056 | Esmaeil Emami | Psychiatry & Neurology | 2955 Franklin Rd, Bloomfield Hills, MI 48302-0917 | 2013-11-04 |
| 1154760312 | Samantha Fugate Kennedy | Psychiatry & Neurology | 909 Fee Rd Ste B119, East Lansing, MI 48824 | 2013-06-21 |
| 1407199961 | David Donald Krohn | Psychiatry & Neurology | 563 Highland Park Dr, Traverse City, MI 49686-2863 | 2013-04-03 |
| 1164712055 | Tatjana Maric | Psychiatry & Neurology | 420 Baltimore Dr Ne, Grand Rapids, MI 49503-3934 | 2011-04-12 |
| 1972893824 | Katherine Barbara Krive | Psychiatry & Neurology | 801 S Waverly Rd Ste 100, Lansing, MI 48917-4200 | 2011-04-12 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1295056653 | Veronica Yap Tan | Psychiatry & Neurology | 23354 Portage Way, Apt. 2212, Novi, MI 48375 | 2010-06-18 |
| 1548588874 | Katie Alanna Keller | Psychiatry & Neurology | 79 Alexandrine West, Detroit, MI 48201 | 2010-05-11 |
| 1538390133 | Behavioral Health Associates Pllc | Psychiatry & Neurology | 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 | 2009-07-30 |
| 1235375775 | Kristine Baker | Psychiatry & Neurology | 721 Cherokee St, Traverse City, MI 49684-1401 | 2009-01-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.